Provider Demographics
NPI:1437102795
Name:WELLS, ROSE ANN (CRNP)
Entity Type:Individual
Prefix:MS
First Name:ROSE ANN
Middle Name:
Last Name:WELLS
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 40430
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36640-0430
Mailing Address - Country:US
Mailing Address - Phone:251-665-8000
Mailing Address - Fax:251-665-8010
Practice Address - Street 1:1660 SPRINGHILL AVE
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36604-1405
Practice Address - Country:US
Practice Address - Phone:251-665-8000
Practice Address - Fax:251-665-8010
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2015-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-026125363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
61825Medicare UPIN
051519287Medicare ID - Type Unspecified